On October 2, 2014, the Douglas County Health Department (DCHD) Lead Poisoning Prevention Program (LPPP) received a 61 μg/dL venous blood lead concentration (VBLC) report describing a 3-year-old female refugee. A VBLC above 45 µg/dL in a child less than 72 months requires an aggressive medical and lead hazard exposure intervention because encephalopathy risk is increased. To achieve these intervention objectives, LPPP managers must determine which LPPP stakeholders can respond, contact the parent/guardian and property owner, alert the LPPP stakeholder network, assess lead hazards in the victim’s environment, ensure the victim has a lead-safe dwelling, and monitor critical medical (e.g., treatment prognosis, VBLC reports, treatment discharge date, etc.) and environmental interventions (e.g., assure all lead-safe environment tasks are completed). This special report describes the DCHD protocol developed to ensure rapid environmental health responses to severe pediatric lead poisoning.